Oncology & Hematology Coding Alert

Question: Should we use V58.1 as a primary diagnosis for chemotherapy treatment?

Wisconsin Subscriber

Answer: Medicare considers V codes supplemental to primary diagnoses and rarely pays for procedures with a V code as the primary condition. Instead, you should list a V code as the secondary diagnosis. For instance, you should use V58.1 (Chemotherapy) as a secondary diagnosis for chemotherapy and assign the appropriate malignant neoplasm code, such as breast cancer (174.x), as the primary diagnosis. Listing breast cancer tells payers why your oncologist used chemotherapy.